Common questions about allergies

What is a common medication mistake that people with allergies make?

People with allergies often take their medications only when they have symptoms that bother them. But to get the most out of your allergy medication, it's best to take it regularly, even when you are not experiencing symptoms. This ensures that you get optimal relief from your medication.

For example, if you're using a medication for seasonal allergies, they are most effective if you start them before you experience symptoms. So it's important to know when your symptoms start each year and to take your medication regularly, as prescribed by your doctor and until the end of the allergy season.

Are there side effects associated with prescription nasal sprays?

Prescription nasal sprays include antihistamines, anticholinergics, and inhaled corticosteroids. When it comes to prescription nasal sprays for allergies, most side effects occur locally in the area of the body where you're applying the medication. Nasal sprays can cause side effects such as nasal irritation, stinging, burning, sneezing, and nosebleeds. Other side effects may include dizziness, dry mouth or throat, throat irritation, changes in taste, and headache. Not everyone will experience these side effects, and the extent and severity may depend on each individual and the specific nasal spray. You and your doctor can determine which medication is most appropriate for you.

Are there side effects associated with oral medications for allergies?

Oral medications (taken by mouth) for allergies include antihistamines, decongestants, and leukotriene receptor antagonists. The side effects depend on the type of medication. Side effects of antihistamines (e.g., cetirizine, desloratadine, loratadine fexofenadine) may include dry mouth, constipation, drowsiness, difficulty urinating, fatigue, headache, nausea, and sore throat.

My nasal spray has a funny taste. Is that normal?

Yes. Some nasal sprays have a slight or odd taste to them. If the taste is bothersome, talk to your doctor to see if you can switch to a different nasal spray; you may have a different response to a different nasal spray.

I have a medical condition. Are there allergy medications that I can safely take?

It depends on your medical condition. For example, people with glaucoma may not be able to take certain oral antihistamines (i.e., chlorpheniramine and diphenhydramine), some nasal sprays (e.g., fluticasone furoate, ipratropium), and all decongestants (pseudoephedrine and phenylephrine), since these medications may increase pressure in the eyes. People with high blood pressure may also not be able to take certain oral antihistamines (e.g., chlorpheniramine and diphenhydramine) and some nasal sprays (e.g., fluticasone furoate). They should also use all decongestants with caution.

There are medications that people with these medical conditions can take. For example, people with high blood pressure who need a nasal spray for allergies can use a corticosteroid nasal spray such as ciclesonide, fluticasone propionate, mometasone, or triamcinolone. If you have a medical condition, talk to your doctor about which treatment is right for you.

How quickly can I expect to get relief from my allergy treatment?

Each medication is different. Inhaled corticosteroid nasal sprays vary in the time they take to start working. Some can begin to work within the first day of use, while others take 2 to 3 days to achieve maximum relief. In general, the full benefits of these nasal sprays are often not seen until about 1 to 2 weeks after starting the medication. Some medications, such as oral antihistamines, start to work within a few hours, some within 20 minutes.

What is the difference between the nasal medications and oral medications for allergies?

Nasal medications (nose sprays) act locally in the nose to help with nasal allergy symptoms such as nasal congestion, runny nose, and swelling. Because nasal medications act at the source of nasal symptoms, the type of side effects someone may experience are usually local, such as nasal irritation, headache, or nosebleed. These side effects depend on the person using the nasal spray – not everyone will experience all the potential side effects of a particular medication.

Oral medications are taken by mouth and nasal medications are inhaled or sprayed in the nose. Because oral medications are ingested into the body, their effects can occur throughout the body, so some people may experience side effects such as constipation, drowsiness, or dry mouth, such as in the case of antihistamines. Oral medications can help with all types of allergy symptoms (nasal symptoms, coughing, and eye symptoms).

If you are considering allergy medications, talk to your doctor about which treatment is right for you.

How long should I stay on my allergy treatment?

If you suffer from perennial allergic rhinitis (year-round allergies), you should stay on allergy treatment throughout the year.

If you suffer from seasonal allergic rhinitis, you should start treatment before the expected allergy season (if you know or can predict when you normally start getting symptoms) and continue treatment until the end of the season to maximize the benefits of the medication.

As part of your treatment plan for both perennial and seasonal allergic rhinitis, you should also avoid your allergy triggers whenever possible to avoid allergy symptoms.

How do corticosteroid nasal sprays work?

Corticosteroids work to inhibit the body's inflammatory response to reduce the inflammation that's involved in an allergic reaction. In allergic rhinitis, the body produces different chemicals that cause inflammation in the nose and nasal passages, leading to bothersome nasal symptoms such as congestion, runny nose, itching, and sneezing. Nasal corticosteroids reduce inflammation by stopping these chemicals from forming, thereby decreasing allergy symptoms.

Are the "steroids" in nasal sprays safe?

When used as recommended by your doctor, the steroids in nasal sprays are generally safe. There have been concerns about whether oral steroid medications and nasal steroid sprays may cause your body to produce less of the natural steroid hormone (cortisol) when given at higher than recommended doses or at recommended doses in susceptible people. Insufficient cortisol may slow the growth rate in children and teenagers. Studies have shown that this does not occur with most corticosteroid nasal sprays when taken in appropriate doses.

Talk to your doctor if you have concerns about your allergy treatment.

I have asthma and am currently on treatment to control my symptoms. Can I also take allergy medications containing corticosteroids?

The short answer to this question is "Yes." The concern here is having too much corticosteroid in your body if you are using an inhaled corticosteroid for asthma and a nasal corticosteroid spray for allergies. Make sure your doctor is aware of all your medications, including your inhaled corticosteroid for asthma. That way, they can suggest an appropriate treatment option for your allergies. If you need to use both an inhaled corticosteroid for asthma and a nasal corticosteroid spray for allergies, you and your doctor should work together to reduce medication use to the lowest effective dose.

I have allergies all year round. Is it safe to take allergy medications every day?

When used appropriately and as your doctor or pharmacist recommends, you can use most allergy medications all year round. Some medications used to treat allergy symptoms, such as nasal decongestants (e.g., oxymetazoline, found in many over-the-counter nasal sprays), should not be used for more than 3 to 7 days because the nasal congestion can return or get worse once you stop the medication. However, most allergy medications can be used throughout the year as long as you are experiencing allergy symptoms.

Should I be concerned that my allergy medication will stop working for me after taking it for a while?

No. Most allergy medications have shown that they are still effective after one year of use. Most people can use them long-term. If you experience a change in your symptoms after using allergy medications for a while, see your doctor, who may need to reassess your allergy treatment.

How do I know whether I have seasonal or perennial allergic rhinitis?

Symptoms for both seasonal and perennial (year-round) allergic rhinitis are generally the same – nasal congestion, runny nose, itching, sneezing, and sometimes watery and itchy eyes. However, symptoms for seasonal allergic rhinitis generally appear according to the season commonly associated with the particular allergy you have. For example, if you have an allergy to tree pollen, your symptoms would usually appear in the spring.

Perennial allergic rhinitis symptoms occur as a result of allergens that you are exposed to year-round, such as dust mites and animal dander. For a diagnosis of whether you have seasonal or perennial allergic rhinitis (or both), you should make an appointment with your doctor.

What are some common seasonal allergens that may be causing my allergies to act up?

The pollen season depends greatly on where you live. For example, people in Barrie, Ontario, usually start having allergies to tree pollen starting mid-March, while people in Vancouver, British Columbia, start to have allergies to tree pollen as early as February.

What are some common indoor allergens that may be causing my allergies to act up?

Common indoor allergens include:

cockroaches

dust mites

animal dander (e.g., from pets such as cats and dogs)

mould

These allergens are usually present all year round.

I tend to get tree allergies. What's the best way to avoid getting allergy symptoms?

Since tree pollen tends to trigger allergy symptoms in the spring, prepare for the season by starting allergy medications before you anticipate symptoms to appear (i.e., in early April). Try to avoid going outside, especially in the morning or on dry, windy days. Keep windows and doors shut and use air conditioning instead. Take a shower and wash your hair after being outside to wash off pollen. Avoid drying your clothes outside during pollen allergy season.

Is there a cure for allergies?

Unfortunately, there is currently no known cure for allergies. People with allergies should work with their health care provider to keep their allergies under control. Allergies can be effectively controlled and managed through a treatment plan that includes avoiding allergens and taking appropriate medication that works for you. Some people may also be considered for allergy shots, which do not cure allergies but can prevent allergy symptoms by getting the immune system to become less sensitive to allergens.

What is the difference between first generation antihistamines and second generation antihistamines?

As their names imply, first generation antihistamines have been around longer than the second generation antihistamines. There is also a third generation antihistamine class. The main difference between them is the first generation antihistamines tend to cause more drowsiness, dry mouth, and dry eyes compared to the second and third generation antihistamines.

First generation antihistamines include chlorpheniramine (Chlor-Tripolon®), diphenhydramine (Benadryl® and various generics), and triprolidine (Actifed® - includes a decongestant). Second generation antihistamines include cetirizine (Reactine® and various generics), fexofenadine (Allegra® and various generics), and loratadine (Claritin® and various generics). A third generation antihistamine is desloratadine (Aerius®).

Can I use nasal sprays and oral medications at the same time for my allergies?

Yes. Sometimes using only one type of medication will not provide enough control over allergy symptoms. Nasal sprays provide a local effect and so work to relieve the nasal symptoms of allergies. If you also have other symptoms (e.g., itchy eyes or coughing), an oral medication (taken by mouth) may help relieve them. So, the combination of a nasal spray with an oral medication may help control most or all allergy symptoms. Talk to your doctor about what is right for you.

Can I develop allergies later in life?

Although allergies most commonly begin in childhood, allergies can begin at any time in a person's life.

I am using a nasal spray for another medical condition I have. Can I also use allergy nasal sprays at the same time?

In general, you can use allergy nasal sprays while using other nasal sprays. Just wait at least 15 minutes after using one medication before using the next medication if you need to use them at the same time. Also, before you start, check with your doctor or pharmacist to ensure there are no drug interactions between the two medications.

What is a pollen count?

Many cities offer daily pollen counts during allergy season. Pollen is the substance plants such as trees, weeds, and grasses use to fertilize new seeds for growth and is the substance that people with seasonal allergies are allergic to. A pollen count is the number of grains of pollen per cubic meter, usually measured over a 24-hour period. Depending on the time of year, counts for specific pollen are higher than for other pollen. For example, tree pollen counts are higher in the spring and ragweed pollen counts are higher in the fall. Pollen counts are also highest in the morning.

How can I tell if I am suffering from a cold or from allergies?

The common cold and allergies can be hard to differentiate because they share many of the same symptoms. However, they are two different diseases and treatments for each are different.

To tell the difference, take a look at the type of symptoms you are experiencing. Symptoms of allergies include itchy eyes, runny nose, sneezing, nasal congestion, and sometimes cough and sore throat. Symptoms of the common cold include similar symptoms of allergies such as cough, sore throat, runny nose, sneezing, and nasal congestion. However, coughing is a lot more common when you have a cold. Other symptoms of the common cold may include general aches, pains, and fever.

The common cold also lasts for only about a week, while allergies last for weeks or even longer. To ensure you're using the right treatment and medication, you need to get a proper diagnosis by visiting your doctor.

What are allergy shots?

Allergy shots, also called immunotherapy, are injections that are meant to build up your immune system so that you are less sensitive to the allergen(s) that cause your allergy symptoms. Allergy shots consist of a very small amount of the allergen. Each time you receive an allergy shot, your body makes antibodies to that allergen. The next time you are exposed to that allergen, the antibodies made by your body block the effects of the allergen so that your symptoms are less severe.

Allergy shots are allergen-specific. For example, if you are allergic to ragweed, you would get an allergy shot that contains very small amounts of ragweed.

People who may benefit from allergy shots are people who have severe allergy symptoms that cannot be adequately controlled by allergy medications despite using them appropriately. Allergy shots can also be used by people who are exposed to a lot of allergens and cannot avoid them.